Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine

Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Subclavian catheter (SCC) related infections are a major cause of morbidity in hemodialysis patients, the vast majority due to staphylococci species Povidone-iodine (PI) has proven anti-staphylococcal activity...

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Veröffentlicht in:Kidney international 1991-11, Vol.40 (5), p.934-938
Hauptverfasser: Levin, Adeera, Mason, A. Jane, Jindal, Kailash K., Fong, I. William, Goldstein, Marc B.
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container_end_page 938
container_issue 5
container_start_page 934
container_title Kidney international
container_volume 40
creator Levin, Adeera
Mason, A. Jane
Jindal, Kailash K.
Fong, I. William
Goldstein, Marc B.
description Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Subclavian catheter (SCC) related infections are a major cause of morbidity in hemodialysis patients, the vast majority due to staphylococci species Povidone-iodine (PI) has proven anti-staphylococcal activity. Therefore, a randomized controlled trial of topical PI ointment was undertaken to evaluate the impact of this prophylactic intervention on the incidence of SCC related infections in hemodialysis patients. The role of S. aureus nasal carrier state in the acquisition of infection was also evaluated. Patients requiring SCC for temporary hemodialysis access were randomized to receive the treatment (T; N = 63) or sterile gauze dressings alone (C; N = 66). Catheter duration ranged from 2 to 210 days in both groups, with a mean of 38.6 days in T and 36.2 days in C (NS). Exit site (ES) infections were significantly less in T (5%) versus C (18%) (P < 0.02); tip colonization (TC) was 17% in T versus 36% in C (P < 0.01), while the incidence of septicemia (S) was also significantly less in C (2%) versus C (17%; P < 0.01). S. aureus nasal carriers were at a threefold higher risk of SCC related septicemia (0.009/day) than noncarriers (0.003/day; P < 0.05). The beneficial effect of PI ointment was most evident in this high risk group of S. aureus carriers: ES = 0% T versus 24% C, TC = 12% T versus 42% C, S = 0% T versus 29% C, P < 0.05. There were no adverse effects of the treatment. The routine application of topical PI ointment to temporary hemodialysis catheter exit sites is effective in reducing SCC related infections.
doi_str_mv 10.1038/ki.1991.297
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Patients requiring SCC for temporary hemodialysis access were randomized to receive the treatment (T; N = 63) or sterile gauze dressings alone (C; N = 66). Catheter duration ranged from 2 to 210 days in both groups, with a mean of 38.6 days in T and 36.2 days in C (NS). Exit site (ES) infections were significantly less in T (5%) versus C (18%) (P &lt; 0.02); tip colonization (TC) was 17% in T versus 36% in C (P &lt; 0.01), while the incidence of septicemia (S) was also significantly less in C (2%) versus C (17%; P &lt; 0.01). S. aureus nasal carriers were at a threefold higher risk of SCC related septicemia (0.009/day) than noncarriers (0.003/day; P &lt; 0.05). The beneficial effect of PI ointment was most evident in this high risk group of S. aureus carriers: ES = 0% T versus 24% C, TC = 12% T versus 42% C, S = 0% T versus 29% C, P &lt; 0.05. There were no adverse effects of the treatment. 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Drug treatments</topic><topic>Povidone-Iodine - administration &amp; dosage</topic><topic>Renal Dialysis - adverse effects</topic><topic>Sepsis - prevention &amp; control</topic><topic>Staphylococcal Infections - prevention &amp; control</topic><topic>Subclavian Vein</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Levin, Adeera</creatorcontrib><creatorcontrib>Mason, A. Jane</creatorcontrib><creatorcontrib>Jindal, Kailash K.</creatorcontrib><creatorcontrib>Fong, I. 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William</au><au>Goldstein, Marc B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>1991-11-01</date><risdate>1991</risdate><volume>40</volume><issue>5</issue><spage>934</spage><epage>938</epage><pages>934-938</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Subclavian catheter (SCC) related infections are a major cause of morbidity in hemodialysis patients, the vast majority due to staphylococci species Povidone-iodine (PI) has proven anti-staphylococcal activity. Therefore, a randomized controlled trial of topical PI ointment was undertaken to evaluate the impact of this prophylactic intervention on the incidence of SCC related infections in hemodialysis patients. The role of S. aureus nasal carrier state in the acquisition of infection was also evaluated. Patients requiring SCC for temporary hemodialysis access were randomized to receive the treatment (T; N = 63) or sterile gauze dressings alone (C; N = 66). Catheter duration ranged from 2 to 210 days in both groups, with a mean of 38.6 days in T and 36.2 days in C (NS). Exit site (ES) infections were significantly less in T (5%) versus C (18%) (P &lt; 0.02); tip colonization (TC) was 17% in T versus 36% in C (P &lt; 0.01), while the incidence of septicemia (S) was also significantly less in C (2%) versus C (17%; P &lt; 0.01). S. aureus nasal carriers were at a threefold higher risk of SCC related septicemia (0.009/day) than noncarriers (0.003/day; P &lt; 0.05). The beneficial effect of PI ointment was most evident in this high risk group of S. aureus carriers: ES = 0% T versus 24% C, TC = 12% T versus 42% C, S = 0% T versus 29% C, P &lt; 0.05. There were no adverse effects of the treatment. The routine application of topical PI ointment to temporary hemodialysis catheter exit sites is effective in reducing SCC related infections.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>1762298</pmid><doi>10.1038/ki.1991.297</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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subjects Acute Kidney Injury - therapy
Administration, Topical
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiseptics
Biological and medical sciences
Catheterization, Central Venous - adverse effects
Humans
Kidney Failure, Chronic - therapy
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Povidone-Iodine - administration & dosage
Renal Dialysis - adverse effects
Sepsis - prevention & control
Staphylococcal Infections - prevention & control
Subclavian Vein
title Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine
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